Timing of Isotretinoin Exposure and Early Postoperative Complications after Anterior Cruciate Ligament Reconstruction
Abstract
Introduction: Isotretinoin (ITN) is widely prescribed for severe acne in adolescents and young adults, a population where anterior cruciate ligament reconstruction (ACLR) is commonly performed. Long-standing concerns about impaired wound healing have prompted many surgeons to delay procedures, despite limited orthopaedic-specific evidence. This retrospective case series evaluates early postoperative clinical complications in patients with documented ITN exposure undergoing ACLR.
Methods: We retrospectively reviewed primary ACLR cases from 2015 to 2025 at a multisite orthopaedic practice with documented ITN exposure within 12 months of surgery and at least 3 months of follow-up. ITN exposure was categorized as perioperative (≤10 days), recent (>10 days to 6 months), or remote (>6 to 12 months). The primary outcome was noninfectious incision-site wound complications. Secondary outcomes included graft-site and surgical complications.
Results: Fifty-nine patients (53% female; mean age 18 ± 5 years; BMI 23 ± 2.9 kg/m2, mean follow-up, 9.3 ± 3.3 months) who underwent autograft ACLR were included. Noninfectious wound complications occurred in three patients (5.1%): two remote exposures (incisional bleeding and hemorrhagic bulla) and one recent exposure (contact dermatitis). One graft-site complication (mini cyclops lesion with associated infrapatellar fat-pad scarring) and five surgical complications (postoperative arthrofibrosis requiring revision surgery) were identified. All…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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